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Background

Percutaneous edge–to–edge mitral valve repair is a non–surgical treatment option for patients with severe mitral regurgitation (MR) who have a high perioperative risk for conventional surgery.

Methods and Results

Between 2009 and 2012 we intended to treat 150 patients with severe MR with percutaneous edge–to–edge mitral valve repair in our center. Routine postinterventional transthoracic echocardiographic examinations revealed the new formation of left ventricular thrombi in 3 out of 150 patients. All three patients suffered from end–stage systolic heart failure with a left ventricular ejection fraction (LV–EF) below 20% and were successfully treated in terms of MR reduction (reduction of at least two MR grades). No thrombus formation was observed in 136 patients with a LV–EF > 20%. Thus the frequency of new left ventricular thrombus formation in the cohort of patients with a LV–EF ≤ 20% was 21 % (3 out of 14 patients). During hospitalization one of the 3 patients died after cardioembolic stroke and consecutive pneumonia. Another patient suffered from a thrombembolic myocardial infarction.

Conclusions

In patients with a severely depressed LV–EF a successful percutaneous edge–to–edge mitral valve repair may lead to a substantial reduction of intraventricular blood flow causing new formation of left ventricular thrombus.

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